Manoa Valley Church
2728 Huapala Street
Honolulu, HI 96822
988-3271

We are now in the process of planning for the 2004-2005 school year. If you are interested in applying, please follow the procedure below for pre-registration. Thank you.

1. Complete the pre-registration form below and send it in with the $15 non-refundable fee to the church office at the above address.
2. Make your check payable to Manoa Valley Church. Please write your child(ren)'s names on the bottom of the check.
3. Final registration forms and other information will be mailed to you in July.

Tuition is $945 for September-May. Tuition is payable in monthly installments at $105 per installment.

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MANOA VALLEY CHURCH AFTER SCHOOL CARE
PRE-REGISTRATION FORM FOR 2004-2005 SCHOOL YEAR

Child's Name:______________________________________Birthdate:________________

School:_____________________________________Grade as of Aug. '04____________

Parent's Name(s):________________________Ph. Res.____________Bus.___________

Address:____________________________________City:_______________Zip:________

My child will need Japanese School Escort Service:
1st bell__________ 2nd bell__________

My child will need Kumon Escort Service_______________

___________________________________
(Parent's signature/date)

For office use: Date received:___________________ Payment made:_________________